The Whooping Cough's Unnecessary Return

By

Paul Howard and James R. Copland

Updated Feb. 15, 2011 12:01 a.m. ET

From the City Journal

Vaccines, which save millions of lives every year, are one of the most successful public-health interventions in the history of modern medicine. Among the diseases that they prevent is the whooping cough. Why, then, is that sickness making a scary comeback in California, which is currently weathering its largest whooping-cough epidemic since 1947, with over 7,800 cases and 10 deaths in 2010? Mainly because more and more parents, worried about the vaccine's supposed side effects, are choosing to delay vaccinating their children—or not to do it at all. This public-health calamity, moreover, comes at a time when the Supreme Court is considering a lawsuit against whooping-cough vaccine manufacturer Wyeth; if successful, the suit would make epidemics much more likely and undermine public confidence in vaccines even further.

Parental concerns about vaccine safety are mostly wrongheaded. Plaintiffs' lawyers, eager to translate junk science into jury awards, have long spread misinformation about the dangers of vaccination. They've been especially successful among the affluent and well-educated, presumably because those groups have greater access to vaccine pseudoscience. Last October, the National Committee for Quality Assurance issued a report finding that vaccination rates among privately insured two-year-olds declined by nearly 4 percent in 2009—even as rates among enrollees in Medicaid, the government-run insurance program for low-income families, increased. In fact, 91.2 percent of children in Medicaid received the measles-mumps-rubella vaccination, compared with 90.6 percent of children in private plans. In California's wealthy Marin County, public health official Fred Schwartz reports that parents are "signing waivers to opt out of immunizing kindergarten-bound children." About 7 percent of all children entering kindergarten in Marin County are unvaccinated, the seventh-highest percentage among California's 58 counties. It isn't surprising, then, that Marin County accounts for 15 percent of all California whooping-cough cases, despite having just 0.67 percent of the state's population.

Today's anti-vaccine hysteria can be traced in part to a 1974 British study that appeared to link the whooping-cough vaccine to rare brain injuries. The study was later debunked, but vaccination rates plummeted for a time in the United Kingdom, Japan, and Sweden. In the United States, rates held steady until 1982, when Lea Thompson's documentary Vaccine Roulette stoked fears—and won an Emmy. Though scientifically unfounded, Thompson's film provoked hysteria, congressional inquiries, and a rash of lawsuits against the pharmaceutical industry. By the mid-1980s, plaintiffs' lawyers were seeking billions in damages, and the price of the whooping-cough vaccine shot up 10,000 percent.

With the vaccine industry on the verge of bankruptcy, Congress stepped in and created the Vaccine Injury Compensation Program (VICP), which took all childhood vaccine cases out of the courts and placed them before a special judicial panel. Nearly 25 years later, the VICP has become one of Washington's rare success stories, offering rapid, fair compensation for the small number of cases in which vaccines have caused serious or life-threatening side effects. Freed from the threat of enormous vaccine-related lawsuits, pharmaceutical companies have seen innovation flourish, inventing new vaccines to prevent cervical cancer and safer versions of older vaccines.

Despite the success of the VICP, plaintiffs' lawyers have never stopped trying to litigate around the program. In October, the Supreme Court heard arguments in Bruesewitz v. Wyeth, a case involving the seizures and mental retardation suffered by an infant vaccinated for whooping cough in 1992. The plaintiffs' lawyers in Bruesewitz argue that cases involving defects in drug design shouldn't be decided by the VICP—and that Wyeth is at fault because it didn't use a supposedly safer vaccine design developed by Eli Lilly in the 1960s. (The Lilly design, by the way, was never certified by the FDA as safer.) This is exactly the kind of case that the VICP was created to prevent. If the Supreme Court finds for the plaintiffs and agrees that cases based on alleged design defects aren't covered by the VICP, we can expect a flood of new lawsuits in the courts making specious claims about the links between vaccination and autism. Vaccine manufacturing in the United States would once again be at risk, and public fears of vaccination would intensify.

The recent outbreak of whooping cough in California has been terrible, but it could get much worse. Before the advent of the whooping-cough vaccine, the debilitating disease struck hundreds of thousands of children annually and killed thousands of them. If fewer children today get vaccinated, what scientists call "herd immunity" declines, meaning that the incidence of disease can grow rapidly and endanger the population at large. (Herd immunity matters because no vaccine is completely foolproof.) So by shunning vaccines, well-intentioned parents hurt both their children and their communities.

Convincing parents to vaccinate their children appropriately is a public-health imperative. Let's hope that the Supreme Court will rule accordingly and leave science to the scientists.

Paul Howard is the director of the Manhattan Institute's Center for Medical Progress. James R. Copland is the director of the Manhattan Institute's Center for Legal Policy.

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